Holly Briere is a nurse navigator who helps patients with cancers of the liver, gallbladder and pancreas. The Upstate Cancer Center also has nurse navigators who specialize in other types of cancer. (PHOTO BY ROBERT MESCAVAGE)
BY AMBER SMITH
While each person’s cancer journey is unique, patients are likely to encounter similar services and treatment options along the way.
Holly Briere, a nurse navigator specializing in cancers of the liver, gallbladder and pancreas, guides us through what the experience may entail. The Upstate Cancer Center offers nurse navigators who specialize in various types of cancers.
STEP ONE: Initial referral to a cancer doctor
A patient’s primary care doctor may refer him or her to a physician at the Upstate Cancer Center for assistance in diagnosing cancer, or for expert care after a cancer diagnosis. Depending on the situation, the first appointment could be with a medical oncologist, a surgeon or a radiation oncologist.
STEP TWO: Meeting the nurse navigator
A nurse navigator becomes the point of contact for patients at the Upstate Cancer Center. The navigator helps coordinate appointments, answer any questions and arrange for services that go beyond standard medical care. “I’m somebody they can always count on,” says Briere.
STEP THREE: Creating a personalized care plan
The patient’s cancer center physician discusses his or her case with a team of doctors, nurses, technicians and other caregivers during weekly multidisciplinary meetings. Each team member can contribute expertise toward the best care plan for the patient, which may include one or more of the therapies listed below in step four:
STEP FOUR: Treatment
— Medical oncology: Chemotherapy refers to any of a variety of medications that are used separately or in combination, in specific dosages and over particular time spans as a method of treating cancer. Sometimes chemotherapy is prescribed as the only treatment. Sometimes it precedes other treatments. It may also be used at the conclusion of primary treatment, to help lower the risk of recurrence.
Among the radiation oncology technology available at Upstate is the Vero, a sophisticated machine that allows tumors to be pinpointed and radiation delivered with precision.
— Radiation oncology: A variety of external beam radiation therapies is available to help shrink tumors before surgery or eliminate microscopic cancer cells after surgery. Today’s advanced radiotherapy machines deliver radiation with unprecedented precision. Brachytherapy is also an option, for tumors that are likely to respond to the temporary placement of tiny radioactive sources.
— Surgery: A surgical team may operate to remove a tumor from a patient with cancer. Surgeons are also involved in the installation of ports to ease chemotherapy administration.
— Palliative care: Depending on the patient’s wishes, a palliative care plan may be crafted to focus on relief from the symptoms and stress of cancer.
STEP FIVE: Survivorship
A patient’s basic health needs changed after a cancer diagnosis. The survivor wellness team at Upstate works with existing health care providers to ensure comprehensive communication and a personalized plan for post-treatment life.
The hepatobiliary team cares for patients with diseases of the liver, gallbladder and pancreas and is one of the multidisciplinary teams at the Upstate Cancer Center. From left are Ajoy Roy, MD, gastroenterologist; Savio John, MD, gastroenterologist; Holly Briere, nurse navigator; Steve Landas, MD, pathologist; Nuri Ozden, MD, gastroenterologist; Rahul Seth, DO, medical oncologist; Dilip Kittur, MD, surgeon; Anna Shapiro, MD, radiation oncologist; Ajay Jain, MD, surgeon; Muhammad Naqvi, MD, medical oncologist; and Olivia King, nurse practitioner. (PHOTO BY SUSAN KAHN)
Other appointments
Nurse navigators can help patients and their loved ones arrange for:
— spiritual care
— genetic counseling
— nutritional advice
— assistance from a social worker
— financial counseling and insurance coverage
— assistance with legal matters
— help conducting library research
— integrative medicine consultations
— psychological counseling
— support group information
— rehabilitation therapy
— fitness counseling
— smoking cessation help
— fertility counseling
— lodging in the Syracuse area during treatment
This article appears in the fall 2016 issue of Cancer Care magazine.
